CPT 00635 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Anesthesia • Anesthesia for Procedures on the Spine and Spinal Cord |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • AA - Anesthesia by anesthesiologist • None • P3 - A patient with severe systemic disease |
| Complexity Level | Low |
National average anesthesia conversion factor for CPT 00635 by major payers:
$57.13
$55.71
$56.33
$54.24
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 00635 | ||||||
United | 00635 | $79.19 | 1629331558 - ERIN ZURFLU | 931048304 - (OR) BEND ANESTHESIOLOGY GROUP, P.C. | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $53.00 | 1982983565 - JOHN LEE | 272767291 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00635 | $81.44 | 1619238045 - LINDSAY LOPATA | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $117.22 | 1982135323 - DAVID JANICZEK | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $65.00 | 1689069940 - NATALIE BODMER | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $40.31 | 1801986377 - SHAILESH SHAH | 710236857 - (AR) ARKANSAS CHILDRENS HOSPITAL | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $67.09 | 1093970766 - LARISSA GREBENCHTCHIKOVA | 943281660 | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $65.00 | 1720275316 - JULIANNE MENDOZA | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $117.22 | 1417450248 - LOGAN WOODHOUSE | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00635 | $38.00 | 1538320544 - RAJESH PATEL | 874199582 - (CA) RAJESH PATEL MD INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00635 | $55.50 | 1043338296 - JANE AHN | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00635 | $50.00 | 1609834167 - JOSEPH GRIM | 1609834167 - (CA) JOSEPH GRIM | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $38.00 | 1447499199 - INSUN LEE | 20696193 - (CA) PAUL E. KIM, MD, INC. | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00635 | $61.00 | 1932594165 - JUSTIN LIBAW | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00635 | $52.00 | 1679653802 - CARLA ST LAURENT | 384212419 - (CA) SOCAL ANESTHESIA SOLUTIONS INC | CA | Anesthesiology Physician (207L00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 00635 vs. Other Anesthesia for Procedures on the Spine and Spinal Cord Codes
The CPT 00635 code is part of the Anesthesia services used for Anesthesia for Procedures on the Spine and Spinal Cord. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 00635 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 00626-CPT | Moderate | Anesthesia For Procedures On The Thoracic Spine And Cord, Via An Anterior Transthoracic Approach; Utilizing 1 Lung Ventilation |
| 00630-CPT | Moderate | Anes Lumbar Region; Nos |
| 00632-CPT | Moderate | Anes Lumbar Region; Lumbar Sympathectomy |
| 00635-CPT | Low | Anes, Lumbar Region Procs; Diagnostic Or Therapeutic Lumbar Puncture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00635 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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